The economic costs of health service treatments for asbestos-related mesothelioma deaths

Our plain-English summary of The economic costs of health service treatments for asbestos-related mesothelioma deaths, by A. Watterson, T. Gorman, C. Malcolm, et al (Annals of the New York Academy of Sciences, 2006).

The study

• Authors: A. Watterson, T. Gorman, C. Malcolm, M. Robinson, M. Beck
• Journal: Annals of the New York Academy of Sciences
• Published: 2006;1076:871-81
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This article explores the complex and neglected picture of occupational and environmental disease healthcare costs specifically relating to asbestos. Diagnosed mesothelioma cases in Scotland in one calendar year were used to investigate the subject in greater depth. Data from UK sources on asbestos disease types recorded in 2000 and their disease treatment costs were obtained. Acute care economic costs of these diseases are estimated. One hundred and twenty diagnosed, recorded, and treated cases of asbestos-related diseases occurred in 2000 in Scotland. Mesothelioma accounted for 100 cases and directly cost Scottish National Health Service hospitals an estimated 942,038 pounds. The estimated UK figure in 2000 was at least 16,014,646 pounds because official figures for diagnosed and recorded deaths from mesothelioma are running at over 1700 a year with rises predicted for 2010 of 2000 deaths. By 2003, 50,000 people in the UK had died from diagnosed and recorded mesothelioma since records began. Earlier disease treatment costs would have been significantly lower than those in 2000 but, at 2000 prices, cost to the UK was roughly 471,019,000 pounds in acute hospital expenditure. Figures for primary care costs, including caregiver costs, are incomplete or unknown. These disease costs are substantial and have some international generalizability. Treatment patterns and costs vary greatly. Many lung cancer cases due to asbestos exposure occur globally for each mesothelioma case. Hence figures provided in this article are certain to be gross underestimates of the total health service and personal economic costs of asbestos illness and treatment in Scotland.

In plain English

This study estimated what hospital treatment for mesothelioma cost the National Health Service (NHS) in Scotland. Using official death records, the authors identified all 100 people (91 men and 9 women) who died in Scotland in 2000 with mesothelioma as a primary or contributory cause. They traced each person's hospital records from diagnosis to death and priced the care using official daily cost figures. Sixty deaths were recorded as pleural mesothelioma and 30 as unspecified, although 27 of those 30 had earlier been diagnosed or treated for pleural mesothelioma. Together the 100 people had 3,388 days of hospital treatment, at an estimated cost of £942,038. Greater Glasgow accounted for 22% of the deaths. The most common recorded occupations were carpenters and joiners (12) and metalworking fitters (12). Extending this crudely to the UK at 2000 prices, the authors put acute hospital costs for the 50,000 UK deaths from diagnosed and recorded mesothelioma by 2003 at roughly £471,019,000. Only acute hospital costs were counted, because primary care data were sparse. The authors concluded the costs were seriously underestimated.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cost-of-illness study using linked national death and hospital records, with costs applied from official per-day hospital cost figures
• Who was studied: All 100 people (91 male, 9 female) who died in Scotland during 2000 with mesothelioma as the primary or contributory cause of death; mean age at diagnosis 68.5 years (men) and 72.8 years (women)
• Exposure: Asbestos exposure was not measured, and fiber types and doses were not studied. The only information available was the occupation and socioeconomic status recorded at death, for 97 of the 100 cases, without work histories.
• Main results:
  • Total estimated hospital cost for the 100 people who died of mesothelioma in Scotland in 2000: £942,038 (£35,073 for day cases, £906,965 for inpatient care)
  • The 100 people had 3,388 days of hospital treatment from diagnosis until death (103 day-case days and 3,285 inpatient days)
  • By death certificate, 60 deaths were mesothelioma of the pleura, 30 unspecified, 6 other sites and 4 peritoneum. 27 of the 30 unspecified cases had previously been diagnosed or treated for pleural mesothelioma.
  • Greater Glasgow had the highest number of deaths, 22% of the Scottish total for 2000
  • The most common recorded occupations were carpenters and joiners (12) and metal working production and maintenance fitters (12)
  • 55 of the 97 people with recorded socioeconomic status (57%) were classed as skilled manual (IIIM)
  • Crude UK-wide extrapolation: at 2000 prices, acute hospital costs for the 50,000 people in the UK who had died of diagnosed and recorded mesothelioma by 2003 since records began totalled roughly £471,019,000
• The authors' conclusion: The authors concluded that their figures seriously underestimated the economic costs of treating asbestos-related disease. They also concluded that NHS treatment costs for mesothelioma and asbestosis are enormous and will remain so over coming decades.
• Limitations the authors state:
  • Only acute hospital costs were counted, because data on primary care treatment were sparse
  • Occupational work histories were not available, so the recorded occupations were of limited use
  • Coding of deaths as unspecified mesothelioma suggests the number of pleural mesothelioma deaths was underestimated
  • The UK-wide figures are crude estimates

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Lung Cancer, Asbestos Exposure.

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